- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $3,981.07 / $15,135.61
| Facility | | $446.68 | $3,981.07 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $380.19 / $380.19 / $380.19
| Facility | 52 | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $165.96 / $489.78
| Professional | | $81.28 | $165.96 | $489.78 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $57.54 / $199.53 / $316.23
| Professional | 52 | $57.54 | $199.53 | $316.23 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $22.91 / $72.44 / $120.23
| Professional | 53 | $22.91 | $72.44 | $120.23 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $91.20 / $114.82 / $204.17
| Professional | | $91.20 | $114.82 | $204.17 |
- Facility/Professional
- Professional
- Modifier
- 52
- Typical Low / Median / Typical High
- $54.95 / $54.95 / $54.95
| Professional | 52 | $54.95 | $54.95 | $54.95 |
- Facility/Professional
- Professional
- Modifier
- 53
- Typical Low / Median / Typical High
- $85.11 / $102.33 / $151.36
| Professional | 53 | $85.11 | $102.33 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $2,511.89 / $4,466.84 / $12,882.50
| Facility | | $2,511.89 | $4,466.84 | $12,882.50 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $100.00 / $158.49 / $295.12
| Professional | | $100.00 | $158.49 | $295.12 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $85.11 / $1,000.00 / $2,041.74
| Facility | | $85.11 | $1,000.00 | $2,041.74 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $95.50 / $154.88 / $309.03
| Professional | | $95.50 | $154.88 | $309.03 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $66.07 / $77.62
| Facility | | $66.07 | $66.07 | $77.62 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $81.28 / $123.03 / $257.04
| Professional | | $81.28 | $123.03 | $257.04 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $58.88 / $144.54
| Professional | | $40.74 | $58.88 | $144.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $102.33 / $186.21
| Professional | | $54.95 | $102.33 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $54.95 / $56.23 / $3,890.45
| Facility | | $54.95 | $56.23 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- 52
- Typical Low / Median / Typical High
- $323.59 / $323.59 / $323.59
| Facility | 52 | $323.59 | $323.59 | $323.59 |
- Facility/Professional
- Facility
- Modifier
- 53
- Typical Low / Median / Typical High
- $81.28 / $81.28 / $81.28
| Facility | 53 | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $724.44 / $851.14 / $851.14
| Professional | | $724.44 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $87.10 / $87.10 / $144.54
| Professional | | $87.10 | $87.10 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $66.07 / $123.03 / $190.55
| Facility | | $66.07 | $123.03 | $190.55 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $77.62 / $120.23 / $245.47
| Professional | | $77.62 | $120.23 | $245.47 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $208.93 / $208.93 / $323.59
| Professional | | $208.93 | $208.93 | $323.59 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $40.74 / $56.23 / $104.71
| Professional | | $40.74 | $56.23 | $104.71 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $1,548.82 / $6,456.54
| Facility | | $467.74 | $1,548.82 | $6,456.54 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $67.61 / $104.71 / $234.42
| Professional | | $67.61 | $104.71 | $234.42 |